A 52-year old male in generally good health began to feel soreness and painful twinges in his fingers. The inflammation was not in the knuckle joints but rather in the tissue surrounding them, which became increasingly red and sensitive to touch. Having previously used Vitamin C (ascorbic acid) and methotrexate in succession to treat a case of idiopathic thrombocytopenic purpura, and having an old prescription for methotrexate, he obtained methotrexate from an online pharmacy and began to take it. After experimenting with levels up to 24 mg of methotrexate 1x/week, he found that a single dose of 10 mg 1x/week sufficed to suppress all signs of inflammation.
A rheumatologist diagnosed the inflammation as a vague kind of arthralgia or myalgia that had no specific name but was similar to arthritis except that it was in the tissue, not the joints.
Over the next five years the man tried to taper off the methotrexate three times, but each time his symptoms quickly returned. So for the succeeding ten years he took the methotrexate at 10 mg/week, not under the supervision of a physician. The inflammation remained completely suppressed, and there were no observable side effects.
After fifteen years of this self-treatment, a new physician suggested that he try to taper off the methotrexate. He did so, reaching zero intake after two months. For six weeks after he reached zero, there were no signs of a rebound of the inflammation. Then he began to feel soreness and painful twinges in his fingers. The skin around several knuckles felt sensitive as it previously had. So he decided to treat himself again.
This time he tried Vitamin C instead of methotrexate. He started to take 2 grams/day of Vitamin C, with food to protect against an acidic stomach. The first day he felt an abdominal cramp for about two hours after taking the Vitamin C. From that time on there were no observable side effects. Over the next three weeks, he twice felt a twinge in one finger. Thereafter he felt nothing.
After four weeks of suppression of inflammation, he tested reducing the dose to 1 1/2 g/day (1500 mg). Several days later one knuckle region became inflamed and sore, while two others appeared red and tender. However, the inflammation, soreness, redness, and tenderness resolved by the end of two weeks at 1 1/2 g/day. He continued taking Vitamin C at this level with no recurrence of symptoms, but eventually an acidic stomach led him to abandon Vitamin C and return to methotrexate.
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Kenneth J. Dillon is an historian who writes on science, medicine, and history. See the biosketch.